Information Collection List

IC Title	Status	Responses	Hours	Dollars	Document Type	Form No.
Clinic Coordinator Interview	New	4	2	0	Form	0920-24CB
Patient Eligibility Screener	New	900	120	0	Form	0920-24CB
Patient Eligibility Screener	New	900	120	0	Form	0920-24CB
Post-clinic Survey	New	900	300	0	Form	0920-24CB
Post-clinic Survey	New	900	300	0	Form	0920-24CB
Post-exposure survey	New	900	300	0	Form	0920-24CB
Post-exposure survey	New	900	300	0	Form	0920-24CB
Pre-exposure Survey	New	900	300	0	Form	0920-24CB
Pre-exposure Survey	New	900	300	0	Form	0920-24CB
Provider Survey	New	40	7	0	Form	0920-24CB
Usability Survey	New	300	90	0	Form	0920-24CB
Usability Survey	New	300	90	0	Form	0920-24CB
User Experience Interview	New	30	10	0	Form	0920-24CB
User Experience Interview	New	30	10	0	Form	0920-24CB
Total burden requested under this ICR:		3974	1129	0
To view an IC, click on IC Title